Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan.
Department of Clinical Laboratory, Nihon University Itabashi Hospital, Tokyo, Japan.
Ann Clin Biochem. 2024 Mar;61(2):107-114. doi: 10.1177/00045632231196045. Epub 2023 Aug 29.
Although venipuncture is minimally invasive, and is the most frequently performed medical procedure, it carries the small risk of causing persistent pain, including nerve damage. Recently, our hospital stopped using 22-gauge needles for venipuncture in outpatients and switched to using only 23- and 25-gauge needles. We investigated the impact of using only the finer needles on the incidence of persistent or neuropathic pain and the prevalence of haemolysis, as well as the impact of haemolysis associated with the needle change on other laboratory data.
We retrospectively collected and analysed data on venipuncture-associated pain complaints made during the 1-year period prior and 1-year period after the change in needles, as well as the frequency of haemolysis before and after the change. We also focused on 90 cases that showed significant haemolysis after the needle change and compared the serum aspartate aminotransferase, lactate dehydrogenase, and potassium levels before and after the needle change.
The incidence of persistent pain was significantly reduced from 1 in 10,825 venipunctures before the change to 1 in 29,747 venipunctures after the change. Notably, no patients experienced neuropathic pain after the change. However, the prevalence of haemolysis was significantly increased. Additionally, the serum aspartate aminotransferase, lactate dehydrogenase, and potassium levels were significantly elevated in the cases that showed moderate to gross haemolysis after the needle change.
Using finer needles involves both advantages and disadvantages, and careful consideration is needed to determine which type of needle is in the best interests of the patient.
虽然静脉穿刺是一种微创操作，也是最常进行的医疗程序，但它确实存在引起持续性疼痛的风险，包括神经损伤。最近，我院停止在门诊使用 22 号针头进行静脉穿刺，转而仅使用 23 号和 25 号针头。我们调查了仅使用更细的针头对持续性或神经性疼痛的发生率以及溶血的发生率的影响，以及与针头更换相关的溶血对其他实验室数据的影响。
我们回顾性地收集并分析了在针头更换前的 1 年和更换后的 1 年期间因静脉穿刺引起的疼痛投诉的数据，以及更换前后的溶血频率。我们还关注了 90 例在针头更换后出现明显溶血的病例，并比较了针头更换前后血清天冬氨酸转氨酶、乳酸脱氢酶和钾水平。
持续性疼痛的发生率从更换前的每 10825 次静脉穿刺 1 例显著降低至更换后的每 29747 次静脉穿刺 1 例。值得注意的是，更换后没有患者出现神经性疼痛。然而，溶血的发生率显著增加。此外，在针头更换后出现中度至重度溶血的病例中，血清天冬氨酸转氨酶、乳酸脱氢酶和钾水平显著升高。
使用更细的针头有利有弊，需要仔细考虑哪种类型的针头最符合患者的利益。
